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Sitting too much will probably shorten your life. Entrepreneurs sit a lot.

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The key to reversing the effects of sitting is not standing – it’s standing up regularly.

Switch up sitting and standing every 30 minutes, advises Cornell University ergonomics team . How would you remember to switch? And who will tell you to keep your back straight?

Every 20 minutes for just 2 minutes. And movement is free. The absolute time that you sit is not as important as breaking up sitting with short, even 2 minute breaks. Checking your posture is key.

The science behind not moving is simple: when muscles don’t contract, they burn less fuel, and the surplus, in the form of blood sugar, accumulates in the bloodstream. Sugar turns into fat. The blood pools in legs and the heart. When this happens if you simply move your body, the blood starts circulating more vigorously. Better blood circulation to the muscles helpsburn sugars.

That is what makes prolonged sitting and standing a surprise enemy of our health. Even more surprising though is the remedy – just getting up and walking around for 2 minutes. When the solution is so simple it is easy to discount. Until you see the actual effect on the body.

That probably explains Darma ‘s Smart Cushionpopularity since it does show your blood pressure and other vital statistics in real time. If before this we knew that sitting was bad, it was easy to discount it since we didn’t immediately see measurable effects what what sitting is doing to us. Not any more.

In the future, I expect there will be technology to show exactly how far we are from developing a certain disease if we keep doing what we are doing. A kind of lifestyle projection tool. With a progress bar. Then there is no more mystery in whether that 2 minutes walk I just too really made me healthier. If the progress bar is half way towards heart disease, I might walk even more often, or change my job altogether.

Treatment of reflex syncope

AV = atrioventricular; BP = blood pressure; PCM = physical counter-pressure manoeuvres; VVS = vasovagal syncope.

a
b

Treatment of reflex syncope

AV = atrioventricular; BP = blood pressure; PCM = physical counter-pressure manoeuvres; VVS = vasovagal syncope.

a
b
Figure 11
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Decision pathway for cardiac pacing in patients with reflex syncope. CI-CSS = cardioinhibitory carotid sinus syndrome; CSM = carotid sinus massage; DDD PM = dual-chamber pacemaker; ILR = implantable loop recorder.

Figure 11
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Decision pathway for cardiac pacing in patients with reflex syncope. CI-CSS = cardioinhibitory carotid sinus syndrome; CSM = carotid sinus massage; DDD PM = dual-chamber pacemaker; ILR = implantable loop recorder.

Current management strategies for OH are summarized in Figure 12 .

Figure 12
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Schematic practical guide for the treatment of orthostatic hypotension.

Figure 12
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Schematic practical guide for the treatment of orthostatic hypotension.

Education regarding the nature of the condition in conjunction with the lifestyle advice outlined in section 5.2.1 can markedly improve orthostatic symptoms, even though the rise in BP is relatively small (10–15 mmHg); raising standing BP to just within the autoregulatory zone can make a substantial functional difference. Ambulatory BP recordings may be helpful in identifying abnormal diurnal patterns. These recordings may also help identify supine or nocturnal hypertension in treated patients.

The expansion of extracellular volume is an important goal. In the absence of hypertension, patients should be instructed to have a sufficient salt and water intake, targeting 2–3 L of fluids per day and 10 g of sodium chloride. 310 Rapid ingestion of cool water is reported to be effective in combating orthostatic intolerance and postprandial hypotension. 311

Several studies that have evaluated the association of vasoactive drugs (i.e. any antihypertensive agents, nitrates, diuretics, neuroleptic antidepressants, or dopaminergic drugs) with OH and falls have yielded contrasting results. 312 However, intensely prescribed antihypertensive therapy can increase the risk of OH. Intensive antihypertensive treatment can be defined as higher doses of antihypertensive medications, an increased number of antihypertensive drugs, or lowering BP to a target <140/90 mmHg. The total number of BP-lowering medications 313 or the use of three or more antihypertensive drugs may be a significant predictor of OH. 314 Angiotensin-converting enzyme inhibitors, angiotensin receptors blockers, and calcium channel blockers are less likely to be associated with OH compared with beta-blockers and thiazide diuretics. 315–318

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